Provider Demographics
NPI:1982478764
Name:SMITH, SYDNE PAIGE (RDH)
Entity Type:Individual
Prefix:
First Name:SYDNE
Middle Name:PAIGE
Last Name:SMITH
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 FORT DR NE APT 2
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-7418
Mailing Address - Country:US
Mailing Address - Phone:301-787-7302
Mailing Address - Fax:
Practice Address - Street 1:9881 BROKEN LAND PKWY STE 102
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-3010
Practice Address - Country:US
Practice Address - Phone:410-381-1344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-13
Last Update Date:2023-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHYG2001214124Q00000X
MD8827124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist